Journal of the Georgia Public Health Association最新文献

英文中文

Georgia’s Critical Access Hospitals: Financial Performance and Process Improvement 格鲁吉亚关键医院:财务绩效和流程改进

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/JGPHA.7.127

William Mase, Bettye A Apenteng, Lisa Carhuff, M. Hanna, K. Boakye, L. Kimsey, Samuel T. Opoku, Charles F. Owens, S. Tedders, Patricia Whaley

Background: Georgia’s Critical Access Hospitals (CAH) are in crisis. Within the last 2 years, four CAHs have closed their doors due to failed financial and operational performance. Evidence points to the risk that several more are on the brink of closure. CAH closures have far-reaching impact on residents. Negative impacts include the extra distance that patients must travel to seek care, the displacement of health professionals and the unravelling of the entire fabric of the communities these hospitals serve. We hope to help participants understand the financial and operational challenges of CAHs, and to identify realistic strategies to enhance the resilience of these hospitals.

背景:格鲁吉亚的危重医院(CAH)正处于危机之中。在过去的两年中，由于财务和运营业绩不佳，四家cah关闭了大门。有证据表明，还有几个国家面临关闭的风险。保健所关闭对居民产生了深远的影响。负面影响包括患者必须走更远的路去就医，卫生专业人员流离失所，以及这些医院所服务的整个社区结构的瓦解。我们希望帮助与会者了解卫生保健机构的财政和业务挑战，并确定切实可行的战略，以增强这些医院的复原力。

引用次数: 0

Dental College of Georgia teams up with Richmond County Health Department to help underserved patients 佐治亚牙科学院与里士满县卫生局合作，帮助缺医少药的病人

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/jgpha.6.309

L. Wilson, M. Peacock, C. Cutler, Jamie De Stefano

Background: The Central Savannah River Area remains, for many of the poor, a dental health care shortage area. Each year, from December to March, fourth-year dental students perform outreach with faculty to search the community for unmet dental needs, including dental caries and periodontal disease, the treatment of which is required for the Central Regional Dental Testing Service (CRDTS) Exam, the dental licensing examination. Methods: Fourth year students at the Augusta University Dental College of Georgia recruit patients for free dental pre-screenings at health fairs, community centers, the Barnyard Flea Market, and the dental school. Persons with periodontitis are invited for further screenings at the dental school where they receive a free dental examination and dental radiographs. Many of these patients present with other dental needs requiring restorations, root canals, and extractions, conditions that potentially could disqualify them from receiving periodontal therapy during CRDTS. Through a collaborative effort with the Richmond County Health Department Dental Clinic, these patients receive the treatment for their acute dental needs, while also qualifying them for the periodontics portion of the exam. Results: Regardless of their qualification status for boards, the program provides referrals for patients to the Dental College of Georgia or the Richmond County Health Department, gives patients a chance to be informed about their oral health status, and gives qualifying patients the potential to receive discounted or even free dental work. The efforts of the senior dental students represent an oral public health service effective in achieving improvements in periodontal outcomes within our community. Conclusions: This program not only benefits the future dentists of Georgia by helping provide licensing board requirements, it also introduces dental students to a more diverse population and provides exposure to public health outreach. In addition, this program offers a valuable service to underserved populations who would otherwise have limited or no access to dental care.

背景:对许多穷人来说，萨凡纳河中部地区仍然是牙科保健短缺的地区。每年从12月到3月，四年级牙科学生与教师一起开展外展活动，在社区中寻找未得到满足的牙科需求，包括龋齿和牙周病，这些疾病的治疗需要通过中央区域牙科测试服务(CRDTS)考试，即牙科执照考试。方法:乔治亚州奥古斯塔大学牙科学院的四年级学生在健康博览会、社区中心、Barnyard跳蚤市场和牙科学校招募患者进行免费牙科预筛查。牙周炎患者会被邀请到牙科学校接受进一步的筛查，在那里他们会得到免费的牙科检查和牙科x光片。这些患者中有许多存在其他牙科需求，需要修复，根管和拔牙，这些条件可能使他们在CRDTS期间无法接受牙周治疗。通过与里士满县卫生部门牙科诊所的合作努力，这些患者接受治疗，以满足他们的急性牙科需求，同时也使他们有资格参加牙周病部分的检查。结果:无论他们的资格状况如何，该计划为患者提供了转介到乔治亚牙科学院或里士满县卫生部门的机会，让患者有机会了解他们的口腔健康状况，并使符合条件的患者有可能获得折扣甚至免费的牙科治疗。高级牙科学生的努力代表了口腔公共卫生服务，有效地改善了我们社区的牙周结果。结论:该计划不仅有利于格鲁吉亚未来的牙医，通过帮助提供许可委员会的要求，它还将牙科学生介绍给更多样化的人群，并提供公众健康宣传。此外，该计划为服务不足的人群提供了宝贵的服务，否则他们将有限或无法获得牙科保健。

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引用次数: 1

Randomness and inference in medical and public health research 医学和公共卫生研究中的随机性和推断性

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.102

Matthew J. Hayat, T. R. Knapp

Background: The purpose of this study was to provide a basis for describing the types of randomness used and statistical inferences reported in the medical and public health research literature. Methods: A study was conducted to quantify the types of research designs and analyses used and reported in medical and public health research studies. A stratified random sample of 198 articles from three top-tier medical and public health journals was reviewed, and the presence or absence of random assignment, random sampling, p-values, and confidence intervals, as well as type of research design, were quantified. Results: Random sampling was used in 58 (29.3%) and random assignment in 21 (10.6%) articles. Most (n=125; 63.1%) research studies did not report random assignment or random sampling; however, statistical inference was applied in more than 90%. Conclusions: Results revealed a concerning overuse of statistical inference. Incorrectly applying statistical inference when not warranted has potentially damaging medical and public health consequences. Researchers should carefully consider the appropriateness of using statistical inference in medical and public health research.

背景:本研究的目的是为描述医学和公共卫生研究文献中使用的随机性类型和统计推断提供基础。方法:进行了一项研究，以量化医学和公共卫生研究中使用和报告的研究设计和分析的类型。对来自三个顶级医学和公共卫生期刊的198篇分层随机样本进行了综述，并对随机分配、随机抽样、p值和置信区间以及研究设计类型的存在与否进行了量化。结果:随机抽样58篇(29.3%)，随机分配21篇(10.6%)。大多数(n = 125;63.1%)研究没有报告随机分配或随机抽样;然而，统计推断应用在90%以上。结论:结果揭示了统计推断的过度使用。在没有必要的情况下错误地应用统计推断，可能会造成破坏性的医疗和公共卫生后果。研究人员应仔细考虑在医学和公共卫生研究中使用统计推断的适当性。

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引用次数: 0

Physician Attitudes Toward the Ethics of Pre-Exposure Prophylaxis (PrEP): Cost, Safety, and Resource Allocation 医生对暴露前预防(PrEP)伦理的态度:成本、安全性和资源分配

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/JGPHA.7.104

J. Grippo, S. Smallwood, Katherine Pincura, T. Wright, William Mase

Background: In the United States, human immunodeficiency virus (HIV) remains a substantial public health issue. There is evidence that the use of antiretroviral medications such as pre-exposure prophylaxis (PrEP) can be a safe and effective primary prevention strategy to reduce new cases of HIV infection. Provider practice behavior as it relates to prescribing PrEP and the potential impact on specific vulnerable populations needs increased attention. Few studies have evaluated the attitudes of physicians towards ethical issues related to prescribing PrEP. Methods: The purpose of the present literature review was to evaluate provider attitudes toward the ethics of prescribing PrEP for individuals at risk of acquiring HIV infection. Searches of the PubMed and Cochrane databases were conducted. Three reviewers independently assessed the relevance of articles and discarded those not directly related to the attitudes of physicians toward ethics of the cost, safety, and resource allocation of PrEP. A total of twenty-one articles were included in the review. Results: Provider attitudes and perceptions focused on three areas: resource allocation, cost, and safety or effectiveness of PrEP. Providers who were hesitant in prescribing PrEP were concerned with the availability of resources, patient adherence, risk of drug resistance, and toxicity. In the studies reviewed, few providers had prescribed PrEP; however, prescribing practices trended upward with time and awareness. Conclusions: Realization of the benefits of PrEP will require a utilitarian ethical approach to identifying the populations that will benefit most, monitoring for adverse effects, addressing costs, and educating and training providers to prescribe PrEP responsibly. Ensuring that PrEP fulfills its potential as part of a combination regimen for HIV prevention requires identification of additional evidence, education, support services, and resources that are needed, as well as the regulatory framework and cost scenarios for access to PrEP.

背景:在美国，人类免疫缺陷病毒(HIV)仍然是一个重大的公共卫生问题。有证据表明，使用抗逆转录病毒药物，如暴露前预防(PrEP)，可成为减少艾滋病毒感染新发病例的一种安全有效的初级预防战略。提供者的做法行为涉及到处方PrEP和对特定弱势群体的潜在影响，需要得到更多关注。很少有研究评估医生对处方PrEP相关伦理问题的态度。方法:本文献综述的目的是评估提供者对HIV感染风险个体处方PrEP的伦理态度。检索PubMed和Cochrane数据库。三位审稿人独立评估了文章的相关性，并丢弃了那些与医生对PrEP的成本、安全性和资源分配的伦理态度没有直接关系的文章。总共有21篇文章被纳入审查。结果:提供者的态度和看法集中在三个方面:资源分配、成本、PrEP的安全性或有效性。在开具PrEP处方时犹豫不决的提供者关注资源的可获得性、患者依从性、耐药风险和毒性。在审查的研究中，很少有提供者开PrEP;然而，处方实践随着时间和意识的增加呈上升趋势。结论:实现PrEP的益处需要一种实用的伦理方法，以确定受益最大的人群，监测不良影响，解决成本问题，并教育和培训提供者负责任地开PrEP。要确保PrEP作为艾滋病毒预防联合方案的一部分发挥其潜力，就需要确定所需的额外证据、教育、支持服务和资源，以及获得PrEP的监管框架和成本设想。

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引用次数: 0

Mock Me! A Guide to Developing a First rate Training tool on a Second rate Budget 嘲笑我!用二流预算开发一流培训工具指南

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.121

G. Baxter

引用次数: 0

Injection drug use and hepatitis C: Interventions in behavioral health settings 注射吸毒和丙型肝炎:行为健康环境中的干预措施

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/JGPHA.7.124

M. Sutton

引用次数: 0

A Clinical Trial to Increase the Identification, Genetic Counseling Referral and Genetic Testing of Women at risk for Hereditary Breast and/or Ovarian Cancer 一项增加有遗传性乳腺癌和/或卵巢癌风险妇女的识别、遗传咨询转诊和基因检测的临床试验

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.125

Ceceilia Bellcross, Christine Stanislaw, April Hermstad, Christine Tallo, C. Leonard

引用次数: 0

Breaking the Chains: A Public Health Approach to Modern day Slavery 打破锁链:现代奴隶制的公共卫生方法

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.129

Rachael Nosin

引用次数: 0

Community engagement to address socio-ecological barriers to physical activity among African American breast cancer survivors. 社区参与解决非裔美国乳腺癌幸存者身体活动的社会生态障碍。

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/jgpha.6.312

Selina A Smith, Mary S Whitehead, Joyce Q Sheats, Brittney Chubb, Ernest Alema-Mensah, Benjamin E Ansa

Background: With high rates of obesity, low levels of physical activity (PA), and lack of adherence to physical activity guidelines (PAGs) among African American (AA) breast cancer survivors (BCSs), culturally appropriate interventions that address barriers to participation in PA are needed.

Methods: To develop intervention content, members of an AA breast cancer support group participated in four 1-hour focus group discussions (related to the barriers to PA, strategies for overcoming them, and intervention content), which were audiotaped, transcribed, and analyzed.

Results: The support group collaborated with researchers to construct the Physical Activity Intervention Developed (PAID) to Prevent Breast Cancer, a multi-component (educational sessions; support group discussions; and structured, moderately intensive walking, strength training, and yoga), facilitated, 24-week program focused on reducing multi-level barriers to PA that promote benefits ('pay off') of meeting PAGs.

Conclusions: Community engagement fostered trust, promoted mutuality, built collaboration, and expanded capacity of AA BCSs to participate in developing an intervention addressing individual, interpersonal, organizational, and community barriers to PA.

背景:在非裔美国人(AA)乳腺癌幸存者(BCSs)中，肥胖率高，体力活动(PA)水平低，缺乏对体力活动指南(pag)的遵守，需要文化上适当的干预措施来解决参与PA的障碍。方法:为了制定干预内容，AA乳腺癌支持小组成员参加了四次1小时的焦点小组讨论(涉及PA的障碍，克服这些障碍的策略和干预内容)，录音，转录和分析。结果:支持小组与研究人员合作构建了预防乳腺癌的身体活动干预开发(PAID)，这是一个多组件(教育课程;支持小组讨论;以及有组织的、中等强度的步行、力量训练和瑜伽)、便利的、为期24周的计划，重点是减少达到pag的多层次障碍，从而促进达到pag的好处(“回报”)。结论:社区参与培养了信任，促进了相互关系，建立了协作，并扩大了AA bcs参与制定干预措施的能力，以解决个人，人际，组织和社区对PA的障碍。

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引用次数: 9

Medicaid Savings Continue in the year After end of Participation in the Program, Money Follows the Person 医疗补助储蓄在参与计划结束后的一年内继续，钱随人而去

Journal of the Georgia Public Health Association

Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.107

Glenn M Landers, Kristi Fuller, Mei Zhou

Background: The aim of this analysis was to compare Georgia’s Medicaid expenditures for participants in the Money Follows the Person (MFP) six months before, 12 months during, and 12 months after MFP participation. Methods: Differences in Medicaid expenditures for three populations of MFP participants (individuals with developmental disabilities, individuals with physical disabilities, and older adults) were compared by use of repeated measures t-tests. Results: Per-member per-month Medicaid expenditures were lower across the three populations when comparing six months prior to transition from an institution to 12 months after leaving the MFP program. Conclusions: The incorporation of features from programs such as MFP into existing state Medicaid long-term services and supports may assist in reducing the growth of future expenditures.

背景:本分析的目的是比较格鲁吉亚参与“人随钱”(MFP)项目6个月前、参与期间和参与后12个月的医疗补助支出情况。方法:使用重复测量t检验比较三个MFP参与者群体(发育残疾个体、身体残疾个体和老年人)医疗补助支出的差异。结果:与从机构过渡到离开MFP计划后的12个月相比，三个人群的每个成员每月医疗补助支出较低。结论:将MFP等项目的特点纳入现有的州医疗补助长期服务和支持可能有助于减少未来支出的增长。

引用次数: 0

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Journal of the Georgia Public Health Association

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